Respiratory Arrest
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 212 carries a community non-dual aged RAF of 0.37, and 2 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 211 when a more severe category in the same disease group is also present.
Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
V28 hierarchy
Trumped by: HCC 211 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 213 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 212 (2)
Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 212?
HCC 212 is "Respiratory Arrest", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 2 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 212?
The community non-dual aged relative factor for CMS-HCC V28 category 212 is 0.37. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.
How many ICD-10-CM codes map to HCC 212?
2 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 212 (Respiratory Arrest) for payment year 2026.
Which categories trump HCC 212 in the V28 hierarchy?
HCC 212 is superseded by HCC 211 (Respirator Dependence/Tracheostomy Status/Complications). When a more severe category in the same disease group is documented, it is counted instead of HCC 212.
Related references
Sources
CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.